To the Editor: We appreciate the response of Dr. Citrome et al. and agree with their points on the use of antipsychotic polytherapy. Polytherapy may, in fact, be a result of shortened length of inpatient hospitalization and the subsequent perceived need to treat patient symptoms more aggressively. It is also possible that the patients discharged receiving polytherapy may be a subset of more refractory patients; however, we were not able to gather such information from this specific study. We recognize the limitations of a retrospective study. The brief period over which the patient information was recorded leaves room for interpretation as to whether the rate of polytherapy was due, at least in part, to cross-titration or was rather a deliberate long-term plan. There is no doubt that more randomized, double-blind studies are needed to ascertain the clinical benefits of antipsychotic polytherapy.